Practice Changes in Glycemic Management and Outcomes in Coronary Artery Bypass Surgery Patients
Autor: | Lori Pennell, Brent Hamar, Joanne Westerfield, Cecilia M. Smith-Snyder, Laurel R. Hudson |
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Rok vydání: | 2005 |
Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty medicine.medical_treatment Population Nurse's Role Perioperative Care Coronary artery bypass surgery Diabetes mellitus Outcome Assessment Health Care medicine Humans Hypoglycemic Agents Insulin Nurse Practitioners Prediabetes Coronary Artery Bypass Practice Patterns Physicians' Intensive care medicine education Aged Retrospective Studies Cardiac catheterization Aged 80 and over Advanced and Specialized Nursing education.field_of_study business.industry Blood Glucose Self-Monitoring Perioperative Length of Stay Middle Aged medicine.disease Impaired fasting glucose Organizational Innovation Cardiac surgery Nursing Evaluation Research Hyperglycemia Practice Guidelines as Topic Emergency medicine Female Cardiology and Cardiovascular Medicine business Total Quality Management |
Zdroj: | The Journal of Cardiovascular Nursing. 20:26-34 |
ISSN: | 0889-4655 |
Popis: | This study aims to evaluate whether a quality improvement initiative in hyperglycemia management could result in substantiated practice changes and improved outcomes for coronary artery bypass surgery patients. Retrospective chart review and analysis of 103 randomly selected patients hospitalized for coronary artery bypass surgery was used. After the glycemia awareness initiative, the perioperative use of intravenous insulin infusion therapy increased in the total population (P = .01) as well as in the diabetes population (P = .03). Frequency of blood glucose level tests ordered for nondiabetic patients increased from 2.8 per day to 4.3 per day (P = .38). Blood glucose values improved in the diabetic population (Ps = .02, .048). The average length of stay improved in all nondiabetic patients (10.7-8.1 days, P = .07) including those who had coronary artery bypass graft surgery with cardiac catheterization (7.8-6.2 days, P = .09) and coronary artery bypass graft surgery with catheterization with complications (15.0-9.0 days, P = .12). The glycemia awareness initiative resulted in a positive impact on practice patterns. Undiagnosed diabetes and impaired fasting glucose are important and unrecognized issues within this hospital population. It is recommended that healthcare practitioners assume that cardiac patients have an increased likelihood of impaired fasting glucose and hyperglycemia. Advanced practice nurses can improve patient outcomes by ordering glucose testing and glycemic management as a routine practice for all cardiac surgery patients, regardless of diabetes diagnosis. Cardiac staff nurses can recommend glucose testing and screening for prediabetes and diabetes as a routine part of all nursing assessment. |
Databáze: | OpenAIRE |
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